Mental Health and Schools
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For information about
mental health and schools, contact:

   Mandy Paradise

  Mental Health and Schools

Child and Adolescent Mental Health

The majority of mental illness onset may occur in early childhood, adolescence, or young adulthood. Adolescent youth are also vulnerable for co-occurring substance use and abuse. Additionally, challenges that do not meet diagnostic criteria, including adverse childhood experiences (ACEs) and life-related mental problems and distress, may appear in in school-age youth and compound mental health issues and concerns.


Current Reality

20% of youth ages 13-18 have, or will have, a serious mental illness.

Mental illness is common during adolescence.

50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24.

Adolescence and young adulthood are critical periods for identification and intervention of mental illness.

The average delay between symptom onset and mental health interventions is 8-10 years.

Early identification and treatment engagement is vital for improved quality of life.

Nearly 50% of students age 14 and older with a mental illness drop out of high school.

Students with mental illness need improved supports to succeed in school, career, college, and life.

Washington youth with co-occurring needs (both mental health and substance abuse) were the least likely to graduate on time (12%) and most likely to drop out (80%).

Youth with co-occurring mental health and substance abuse needs are less likely to graduate from and more likely to drop out of high school than youth without co-occurring needs.

In Washington, over 50% of youth in grades 10 and 12 reported not being able to stop or control worrying in the past 2 weeks. Over 60% of youth in grades 10 and 12 reported feeling nervous or anxious.

Youth are affected by mental distress caused by environmental stressors (examples: family crisis, end of a significant relationship, or death of a loved one). This impacts their daily experience in school and at home.

In Washington, over 30% of youth in grades 10 and 12 reported depressive feelings, including feeling sad or hopeless for at least two weeks in the last year. Over 25% of 8th graders reported depressive feelings.

Research consistently shows a strong link between suicide and depression. A diagnosis of depression elevates a person’s risk for suicide.

In Washington, one in five 10th graders seriously considered suicide in the past year. Between 14%-16% of youth in grades 8, 10, and 12 reported they made a plan for how they would attempt suicide.

There are many risk factors for suicide, including having a mental disorder, substance-abuse disorder, or co-occurring disorder.

Information adopted from:
National Institute for Mental Health
2016 Healthy Youth Survey Data
Mental Health Reporting
Suicide Awareness Voices of Education
National Alliance on Mental Illness

Resources for Families:

Resources for Schools and Educators:

School-Based Mental Health: Achieving Integrated Supports
Start here to improve understanding, awareness, and implementation of school mental health. Resources in this section include:

  • Training videos
  • Frameworks and guidance documents
  • Key resource sites
  • Examples and models (coming soon)

Training Videos - Mini Series
This 3-video series is the perfect primer for exploring school-based mental health within a multi-tiered system of support (MTSS). The concepts are excellent and applicable for all, please excuse the grantee-focused introductions in the videos.

  1. Interconnected Systems Framework: The “What and Why” of ISF (1 of 3)
    Following the Interconnected Systems Framework requires integrating school mental health and PBIS efforts. Ultimately supporting behavior, academics, and mental health. 12 minutes
  2. Interconnected Systems Framework: The “How” of ISF (2 of 3)
    An overview with sample models and structures. Topics include: “core plus more” and concepts of function-informed vs. function-based interventions. 13 minutes
  3. Interconnected Systems Framework: The “How” of ISF (3 of 3)
    A comprehensive snapshot of “before” and “after” ISF at state, district, and school building levels. Examples of how data, systems, and practices can be utilized for improved outcomes for students. 15 minutes

Frameworks and Guidance Documents
Sources and materials for understanding and implementing school mental health.

Advancing Education Effectiveness: Interconnecting School Mental Health and School-wide Positive Behavior Support
Edited by Susan Barrett, Lucille Eber, & Mark Weist

Office of Superintendent of Public Instruction’s Health and Physical Education K-12 Learning Standards
The Washington State K–12 Learning Standards provide the foundation for curriculum development. The Health Education and Physical Education K–12 Learning Standards support instruction in these two specific subject areas

School Mental Health Referral Pathways Toolkit (SMHRP)
Published by SAMSHA, 2015

Wisconsin State’s School Mental Health Framework and Needs Assessment Survey

Key Resource Sites:

Behavioral Health Overview
Substance Abuse and Mental Health Services Administration (SAMHSA) website

How to Respond: Injury and Illness in Schools (Washington State)
A pdf document available free online for Washington schools and staff. See “Behavioral Health” section

Interconnected Systems Framework (ISF) – Midwest PBIS Network
A rich site with tools, archived presentations & trainings, and resources

NPR Presents: A Silent Epidemic
Public schools are struggling to handle millions of students with mental health problems. Here’s why.

School Mental Health Assessment, Research, & Training (SMART) Center, University of Washington
The UW’s SMART Center promotes quality improvement of school-based mental/behavioral health services, thereby preventing or ameliorating mental health problems more effectively and promoting the social-emotional and academic development and success of youth across school, home, and community contexts.

Washington School-Based Health Alliance
Committed to advancing health care access in schools and ensure the health and academic success of youth statewide. The Alliance facilitates students’ access and utilization of health services in school.

UCLA’s Center for Mental Health in Schools

OSPI Resources

DBHR Children's Behavioral Health page

Health and Physical Education K-12 Learning Standards
The Washington State K–12 Learning Standards provide the foundation for curriculum development. The Health Education K–12 Learning Standards support instruction in health specific subject areas (includes information on Emotional and Mental/Behavioral health)

Compassionate Schools

Integrated Student Supports

Multi-Tiered System of Supports

Student Assistance Program


   Updated 11/3/2017

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